King Louis XIV: A Disastrous Ruler Essay -- European History Essays

King Louis XIV: A Disastrous Ruler It is often debated whether or not the reign of King Louis XIV had a positive or negative effect on France. Although there were improvements during his reign in transportation, culture, and national defense, there were far more negative aspects. He depleted the national treasury with his liberal spending on personal luxuries and massive monuments. His extreme fear of the loss of power led to poor decision making, which caused the court to be of lower quality. King Louis XIV’s disastrous rule brought about a series of effects that influenced the French Revolution in the following century. King Louis XIV's 72 year reign was incredibly influential in shaping French history. King Louis XIV’s childhood was traumatic because of â€Å"La Fronde† which was a noble rebellion against the monarchy. This experience taught King Louis XIV to distrust the nobles. It was for this reason that he eventually excluded nobility from the council and surrounded himself with loyal ministers whom he could control. He also separated the aristocracy from the people of France by moving the court to the Palace of Versailles. One of the most notable of King Louis XIV’s decisions was that he refused to appoint another Prime Minister after the death of Prime Minister Mazarin. Every decision, from the declaration of war to the approval of a passport, went through him personally. During his reign as king, France participated in several wars including the War of Devolution, in Anglo-Dutch War, and the War of the Spanish Succession. Another major action he took was the proclamation of the Edict of Fontainebleau, which revoked the Edict of Nantes, imposing religious uniformity through Catholi... ...roblems and turned a great number of people against the monarchy. These events lead to the resentment that was another key factor in beginning the French Revolution. The end of King Louis XIV’s rule was especially disastrous. After the death of his advisor Colbert, King Louis XIV made even more horrible and costly decisions. He further enlarged the military and entered into many wars in which he lost a great deal of her newly acquired territories and increased the national debt even more. In short, the reign of King Louis XIV had a disastrous impact on France. His liberal spending, appointing of easily controlled people to court, revoking the freedom of religion, and poor decision making sparked the economic burdens and resentment of the aristocracy that were major factors in the French Revolution and the eventual downfall of the French monarchy.

McGraw-Hill Financial Performance

It is reported that there was an 8.6% increase in the earnings per share to $2.40 for the year 2006 that due to the increase in the revenue by 4.2% amounting to $6.3 billion.   Another successful year for the McGraw-Hill, but before that, let’s take a look on the past few years where the evaluation on this research must focus. The net income of the McGraw-Hill for the year 2003 is $687.7 million.   During 2004, the net income had reached to an amount of $755.8 million, a 9.9% increase from the previous year.   In addition to this, the company’s revenue increased by 7.4% amounting to $5.3 billion. In accordance with the Emerging Issues Task Force Issue 00-10, â€Å"Accounting for Shipping and Handling Fees Costs†, the corporation had made reclassification of the revenues resulting to an increase in the revenue of $62.5 million and $62.5 million during the year 2004 and 2003 respectively. There is an increased of 14.3% in the McGraw-Hill revenue during 2005 which had reached about $6 billion.   Together with it is the increase in the net income of 11.7% reaching to an amount of $844.3 million and also an increase in the earnings per share of 12.8%.   The company had also returned an amount greater than $924 million to the shareholders prior to the increase of 14.4% compared to as before of 4.9%. Pearson PLC Financial Performance In the year 2003, changes in the company’s portfolios had made revenue to increase by  £89 million and  £24 million on the profit.   However, due to the movements of currency, there is  £181 million reduction on the revenues and  £27 million on the profits. During the year 2004, the revenues of the Pearson PLC had decreased by  £302 million and  £51 million on the profits due to the currency movements that happened that time.   However, the changes in the portfolio had made an increase of  £41 million on the revenues but still the profit dropped down by  £8 million. However, the movements of the currency in 2005 had made a positive effect on the Pearson PLC.   Regarding the continuing business basis, there is an increase in the sails by  £46 million and the profit had also increased by  £12 million.   In addition to this, the portfolio changes also made the sales to increase by  £29 million and profits by  £9 million. Also during the year 2005, the fastest growth of sales happened in comparison on the past five years of the corporation.   The sales increased by 9%.   There is also a 22% increase in the profit amounting to  £509 million and with the margins going up to 12.4%.   There is also an increase of more than 33% in the operating cash flow of Pearson and more than 50% on the free cash flow, reaching to an amount of  £431 million. These results to the most cash generated in Pearson that ever happened before.   The biggest contributor on these success is the –education- having sale of up to 12% generating an amount of  £2.66 billion and making the profit to go up by 22% to the amount of  £348 million. McGraw-Hill Stock Performance A 10% increase was approved by the Board of Directors of the McGraw-Hill Companies on the Corporation’s common stock regular quarterly cash dividend.   It was the 32nd of the consecutive increase in the annual dividend of the Corporation’s common stock. In 2004, an amount of $630 million was returned by the McGraw-Hill Companies to their shareholder.   There was a 50% increase on the dividend payments compared to the previous year (2003).   There is a new annualized rate amounting to $1.32 per share brought by the Corporation’s increase by 3 cents to 33 cents per share in the regularly quarterly dividend on the common stock.   There was a history of continued increase in the McGraw-Hill dividends for 32 consecutive years.   Also, during this year, the acquisition of the 5 million shares of its repurchase range happened on the Corporation. There was an increase of a 10.3% average on the McGraw-Hill Companies annualized total return over the past 5 years. In 2005, the expanded stock repurchase program continued for 45 million shares which is far greater than the outlook of the Corporation on 2004 of between three to five million shares.   In addition to this, it has been a 33 consecutive years of an increase in the dividend.   Since 1974, a 10.3% had been the average compound annual growth rate. Pearson Stock Performance The shareholders had approved the amount of 17 pence per ordinary share as a final dividend in 2005 and the he total dividend had reached the amount of 27 pence (adding the already paid interim dividend).   There is an increase from the previous year dividend from 25.4 pence (2004). In 2004, an adjustment of up to 5% amounting to 30 pence (57.6 cents) per share occurred and also there was an increase on the dividends by 5%. In 2003, a dividend per share amounts to 24.2 pence or 43.3 cents.   The price of the share at this year is  £5.72 and  £6.25 on the following year (2004) and on 2005, the share price is  £6.52. Stock Performance Analysis In 2004, the stock performance of the McGraw-Hill dramatically increased from 17.8% of return putting it on its peak having a record giving a 32.9% in return to the shareholders.   However, it has not been good during the year 2005 due to the currency movement thus dropping down to 14.4%.   However, it was a disaster for Pearson PLC’s stock to be performing to the down low having its percent of return down to its lowest return of 1.5%.   The stock performance trend from 2003 until 2005 has been continuously going down.   Currency movement and the changed company portfolio didn’t make a resistance for the company at these times. Long-Term Commitment Until 2005, McGraw-Hill Companies had succeeded and made the constant average return on investments through dividends of 10.3% for 33 consecutive years since 1974.   By simply looking at these numbers, the possibility of McGraw-Hill to a long-term commitment would bring up more success to the Corporation. Pearson had been facing trouble in their past years before 2003.   Those years have been tough for the Corporation.   But their claim is they had made three of their companies, namely education, business information and consumer publishing to becoming world leaders. These happenings made them to think of two things; making their operations efficient and selling of better products and services compared to their competitors.   This strategy made them sold more than  £250 million worth of products and services through combining of two or more parts of Pearson, both working together.   The results of this had reduced costs, increased revenues, assets, and working capitals that will continue planning on a long-term commitment. McGraw-Hill. (2007). The McGraw-Hill Companies, Inc.: Financial Statement.  Ã‚   Retrieved March 10, 2007, from http://moneycentral.msn.com/investor/invsub/results/statemnt.aspx?Symbol=MHP&lstStatement=Balance&stmtView=Ann PLC, P. (2007). Financial Statement.  Ã‚   Retrieved March 10, 2007, from http://finance.google.com/finance?fstype=ci&cid=664805      

Nursing Practice and Profession Abstract

AbstractNurses committed to the interpersonal caring hold themselves accountable for the human well being of patients entrusted to their health care. Being accountable means being attentive and responsive to the health care needs of individual patient. It means that my concern for the patient transcends whatever happens during my shift, and that I ensure continuity of care when I leave the patient. In today’s highly fragmented system of care, patients often find themselves unable to point to any one care giver who knows the overall situation and is capable and willing to coordinate the efforts of the healthcare team. Being responsive and responsible earns a patient’s trust that â€Å"all will be well† as the healthcare needs are addressed. This will be the central them of this paper in the quest of establish the nurse’s accountabilities in evaluating or implementing change.Nurses who are sensitive to the legal dimensions of practice are careful to develop a strong sense of both ethical and legal accountability. Competent practice is a nurses’ best legal safeguard. When working to develop ethical and legal accountabilities, nurses must recognize that both deficiencies and or excesses of responsible caring are problematic.Although it is reasonable to hold oneself accountable for promoting the human well being of the patients, nurses can err by setting unrealistic standards of responsiveness and responsibility for themselves. Prudence is always necessary to balance responsible self care with care for others. Inexperienced nurses might feel totally responsible for effecting patient outcomes beyond their control and become frustrated and sad when unable to produce the desired outcome Conversations about what is reasonable to hold ourselves and others accountable for are always helpful.Each employing institution or agency providing nursing service has an obligation to establish a process for reporting and handling practices by indiv idual or by health care systems that jeopardizes a patient’s health or safety. The American Nurses Association code of Ethics obligates nurses to report professional conduct that is incompetent, unethical or illegal. For nurses, incompetent practice in measured by nursing standards, unethical practice is evaluated in light of the professional codes of ethics, while illegal practice is identified in terms of violation of federal legislations and laws.Nurses must respect the accountability and responsibility inherent in their roles.   They have the moral obligations in the provision of nursing care, hence they collaborate with other health care providers in providing comprehensive health care, recognizing the perspective and expertise of each member.   Nurses have a moral right to refuse to participate in procedures that may violate their own personal moral conscience since they are entitled to conscientious objection. They must keep all information obtained in a profession al capacity confidential and employ professional judgment in sharing this information on a need to know basis. Nurses are expected to protect individuals under their care against lack of privacy by confining their verbal communications only to appropriate personnel; settings, and to professional purposes. They are obliged to adhere to practice that limits access to personal records to appropriate personnel.They must value the promotion of a social as well as economic environment that supports and sustains health and well-being. It includes the involvement in the detection of ill effects of the environment on the health of the patient as well as the ill effects of human activities to the natural environment. They must acknowledge that the social environment in which the patient inhabits has an impact on health. Nurses must respect the rights of individuals to make informed choices in relation to their care. They have this responsibility to inform individuals about the care available to them, and the choice to accept or reject that care.   If the person is not able to speak for themselves, nurses must ensure the availability of someone to represent them. It is vital to respect the decisions made concerning the individual’s care.Standards of care are one measure of quality.   Quality nursing care provides care by qualified individuals. Likewise, the individual needs, values, and culture of the patient relative to the provision of nursing care is important to be respected and considered hence it should not be compromised for reasons of ethnicity, gender, spiritual values, disability, age, economic, social or health status, or any other grounds.   Respect for an individual’s needs includes recognition of the individual’s place in a family and the community. It is due to this reason that others should be included in the provision of care, most significantly the family members. Respect for needs, beliefs and values includes culturally sensi tive care, and the need for comfort, dignity, privacy and alleviation of pain and anxiety as much as possible.â€Å"Evidence-based practice (EBP) is a problem solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician’s expertise as well as patient preferences and values to make decisions about the type of care that is provided† (Melnyk, 2004). Quality of care outcomes refers to accuracy and relevance demonstrated by the decisions concerning the need for medical and surgical intervention. Evidence of appropriateness in healthcare is necessary to improve health outcomes, balance costs, provide guidance to physicians and meet the need of the new informed health consumer. Appropriateness is unlike effectiveness since the later refers to the degree in which an intervention achieves the objectives set (Muir Gray, 1997). One criterion of appropriateness is that of necessity.As technology and improved methods o f care has advanced, access to appropriate interventions should likewise improve. Today some interventions are still limited such as magnetic resonance imaging (MRI) in rural communities and since access to this technology is limited, a criterion of necessity is used to determine who is able to access and how quickly. Therefore although use of MRI may be appropriate in diagnostics, it may be underused. Advancements in technology, interventions and clinical research will provide updated evidence which in turn would affect ratings of appropriateness (Muir Gray, 1997). Clinical guideline statements are developed from evidence to assist healthcare practitioners in making appropriate health interventions (Woolf, Grol, Hutchinson, Eccles & Grimshaw, 1999).The clinical guideline may be a general statement or concise instruction on which diagnostic test to order or how best to treat a specific condition. The purpose of clinical guidelines is as a tool for making decisions that will result i n more consistent and efficient care. Guidelines are not rules nor are they mandatory. The benefits of clinical guidelines include: Improved health outcomes; Increased beneficial/appropriate care; Consistency of care; Improved patient information; Ability to positively influence policy; Provide direction to health care practitioners;ReferencesAgency of Healthcare Research and Quality. (n.d.). Outcomes research fact sheet. [Online].Available: https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/index.htmlBrook, R.H. (1994). Appropriateness: The next frontier. [Online]. Available:http://www.bmj.com/content/308/6923/218.full?ijkey=t7GNbMJu0NIhAFitch, K., Bernstien, S. J., Aguilar, M. D., Burand, B., LaCalle, J. R., Lazaro, P. van het Loo,McDonnell, J., Vader, J. P., & Kahan, J. P. (2001). The RAND/UCLA appropriatenessmethod user’s manual. [Online]. Available:http://www.rand.org/pubs/monograph_reports/MR1269.html?John A. Hartford Foundation. (n.d.). [Online]. Available: http://www.johnahartford.org/Muir Gray, J.A. (1997). Evidence-based healthcare: How to make health policy and managementdecisions, New York: Churchill Livingstone.Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999). Clinical guidelines:Potential benefits, limitations and harms of clinical guidelines. [Online]. Available:http://www.bmj.com/content/318/7182/527.full

Analyzing Ethical Behavior Paper Essays

Analyzing Ethical Behavior Paper Essays Analyzing Ethical Behavior Paper Essay Analyzing Ethical Behavior Paper Essay Ethics codes are retreated to help maintain a satisfactory level of ethical behavior within a business or organization and to help companies function more successfully (Mallow, Barnes, Bowers, Landwards, 2013, p. 101). Codes of ethics are broken numerous amounts of times in the business world. When these codes are broken, it can lead to multiple complications and scandals for corporations. Two examples of scandal and fraud in the business world are Bernard Lawrence Maddox and ENRON. Bernie Maddox Analysis Bernard Lawrence Maddox was the chairman for an investment securities firm that he founded in 1960. He was convicted of fraud in 2008 when he admitted that his business was, in fact, the largest Opinion scheme in history. Approximately $20 billion of, so-called, investments had dissipated (Kramer Ward, 2009, p. 27). In the case of Bernie Maddox, there were several investigations and red flags that appeared throughout each investigation. For instance, the fact that Maddox hardly ever encountered a down or slow month even in inconsistent markets raised quite a few suspicions. During the time of investigation, Bernie Maddox also confessed to operating a pyramid chem. as well as using a particular investment strategy called, split-strike conversion. This investment strategy entails buying and selling different sorts of options to reduce volatility (The Maddox affair:, 2008, Para. 7). Bernie Maddox is extremely smart and sneaky in a sense that he manipulated several people into investing in his Opinion scheme. Maddox took millions of dollars from huge corporations and companies. The fact that Madams company had never truly experienced a downfall should have been a major red flag to those who had invested in the company. Maddox portrayed his Opinion scheme in a way where people liked what they heard, liked what they saw, and therefore, invested immediately into the company without doing any further research. Maddox is a master manipulator, and his lack of ethics caused people to lose nearly their entire life savings. Although Bernie Maddox may have been the mastermind behind this scheme, he is not the only one to blame. There were multiple people working under Maddox. The code of ethics, or lack thereof, really shows here because if someone working in the company had any knowledge of what was going on in regards to the Opinion chem., he or she should have had the courage and honesty to go to someone of higher authority and report what Maddox was doing. If someone had any code of ethics or integrity, he or she should have thought about the lives that Madams Opinion scheme was affecting, and the illegal activity should have been reported immediately. Due to the lack of a code of ethics, multiple people lost a great amount of money by investing in Madams Opinion scheme. Bernie Maddox has an incredibly selfish view Of ethics and corporate responsibility towards his stakeholders. All that was on his mind at the time of the scheme was getting more money and being wealthy. He didnt care who he was affecting in a negative way, just as long as he benefited in the end; which is ironic since he ended up in prison with a 150-year sentence. ENRON Analysis ENRON Corporation was an energy and services company located in Texas. It went bankrupt in December of 2001 due to a planned accounting fraud. This accounting fraud led to several questions and concerns, not only about ENRON, but also about the accounting and financial companies working for ENRON. ENRON lied about its profits and stands accused of a range of shady dealings, including concealing debts so they didnt show up in the companys accounts (Enron Scandal at-a-glance, 2002, Para. 3). ENRON had close ties to the White House, therefore creating political implications as well. The lack of ethical standards for ENRON is obvious in this scandal. Executives and employees of the corporation were sneaky liars. They manipulated financial reports and accounts to make it appear as if the company was in good standing when it really wasnt. ENRON Corporation has a manipulative, unethical view on ethics and corporate responsibility. Because the corporation lied about numerous things regarding the finances and accounting, this implies that there was a huge lack of ethics within the company. The fact that executives and employees were okay with lying about so many records leads people to believe that the entire ENRON Corporation was set on a lie. ENRON, as well as accounting and financing companies, betrayed the trust Of several people because Of this scandal. Conclusion In sum, both the Bernie Maddox scandal and the ENRON scandal lacked a retain code of ethics and, as a result, both corporations no longer exist in the business world and executives and employees at each of these corporations faced life long consequences.

Turkey in the European Union

Turkey in the European Union The country of Turkey is typically considered to straddle both Europe and Asia. Turkey occupies all of the Anatolian Peninsula (also known as Asia Minor) and a small part of southeastern Europe. In October 2005 negotiations began between Turkey (population 70 million) and the European Union (EU) for Turkey to be considered as a possible member of the EU in the future. Location While most of Turkey lies geographically in Asia (the peninsula is Asian), far western Turkey lies in Europe. Turkeys largest city of Istanbul (known as Constantinople until 1930), with a population of over 9 million is located on both the east and west sides of the Bosporus strait so it straddles both what are traditionally considered Europe and Asia. However, Turkeys capital city of Ankara is fully outside of Europe and on the Asian continent. While the European Union is working with Turkey to help it move toward being able to become a member of the European Union, there are some who are concerned about Turkeys potential membership. Those opposed to Turkish membership in the EU point to several issues. Issues First, they state that Turkeys culture and values are different from those of the European Union as a whole. They point out that Turkeys 99.8% Muslim population is too different from Christian-based Europe. However, the EU makes the case that the EU is not a religion-based organization, Turkey is a secular (a non-religion-based government) state, and that 12 million Muslims currently live throughout the European Union. Nonetheless, the EU acknowledges that Turkey needs to Substantially improve respect for the rights of non-Muslim religious communities to meet European standards. Secondly, naysayers point out that since Turkey is mostly not in Europe (neither population-wise nor geographically), it should not become part of the European Union. The EU responds that, The EU is based more on values and political will than on rivers and mountains, and acknowledges that, Geographers and historians have never agreed on the physical or natural borders of Europe. Too true! A third reason Turkey might have problems is its non-recognition of Cyprus, a full-fledged member of the European Union. Turkey will have to acknowledge Cyprus to be considered a contender for membership. Additionally, many are concerned about the rights of Kurds in Turkey. The Kurdish people have limited human rights and there are accounts of genocidal activities that need to stop for Turkey to be considered for European Union membership. Finally, some are concerned that Turkeys large population would alter the balance of power in the European Union. After all, Germanys population (the largest country in the EU) is only at 82 million and declining. Turkey would be the second largest country (and perhaps eventually the largest with its much higher growth rate) in the EU and would have considerable influence in the European Union. This influence would be especially profound in the population-based European Parliament. The low per-capita income of the Turkish population is also of concern since the economy of Turkey as a new EU member might have a negative effect on the EU as a whole. Turkey is receiving considerable assistance from its European neighbors as well as from the EU. The EU has allocated billions and is expected to allocate billions of euros in funding for projects to help invest in a stronger Turkey that may one day become a member of the European Union. I was particularly moved by this EU statement on why Turkey should be part of the European Union of the future, Europe needs a stable, democratic and more prosperous Turkey which adopts our values, our rule of law, and our common policies. The accession perspective has already driven forward bold and significant reforms. If the rule of law and human rights are guaranteed throughout the country, Turkey can join the EU and thus become an even stronger bridge between civilizations as it is already today. That sounds like worthwhile goal to me.

Assessment of Glenda Medical Condition

Chronic kidney disease abbreviated as CKD is also referred to as the chronic renal failure and it is responsible for most cases of mortality and morbidity in the elderly in Australia (Wen et al., 2014). Moreover, CKD is associated with reducing the significant role of the kidney through causing damages and blockage (Vassalotti et al., 2016). Research shows that the period it takes for CKD to cause complete renal failure depends on the stages of CKD and the nursing interventions in place (Tonelli and Wanner, 2014). Notably, it should be made clear that chronic kidney disease has no cure, but early identification and application of nursing intervention as per Levett-Jones clinical reasoning cycle will help slow the progress and improve the patient's symptoms. As of the year 2005, the NHS reported that chronic kidney disease is at an alarming rate as most of the hospitals in the region reported to have increased renal replacement surgery (Gatchel et al., 2014). Also, according to Hung e t al., 2014 are of the opinion that chronic kidney disease increases the chances of cardiovascular complications. Again, a report by the WHO indicated that there would be high chances of chronic kidney disease in Australia for the next ten years and the likelihood of the cases leveling off are dismal due to the lifestyle of locals (mostly the native Australians) who are reluctant to seek medication from public hospitals (Collins et al., 2015). The underlying factor towards the behavior by most natives is cultural-based. The residents feel left behind regarding development and that the foreigners are interfering with their way of life (Tong et al., 2015). With that in mind, the case focuses on describing the care, management, and assessment interventions for Glenda, a 46-year-old woman who presents with chronic kidney disease. The previous medical history indicates the following symptoms generalized swelling of the face, hands, feet, and ankles. Also, she finds difficulty in walking due to stiffness and pain in her knee and elbow joints. Her current medical condition indicates increased body temperature of 38.8 degrees Celsius and increased blood pressure of 180/100 mmHg which relates to the high number of cigarettes consumed daily. As such, Glenda is taken to the emergency renal ward at Darwin hospital where she undergoes an X-ray, EUC, and ECG. After inserting a vas catheter, Glenda is scheduled for surgery in a week's time to have fistula formation in her left arm.   The condition makes Glenda admitted for almost twelve months a situation that makes her daughter Roseen uncomfortable. Later, the nurses, family, and friends organiz ed a meeting and ensure Glenda is discharged and receives medication from her home in Tiwi Island and undergo her dialysis at Renal Dialysis unit at Wurrumiyang clinic. As such, ideas in this article seek to critique the care, management, and assessment for Glenda at each stage of her chronic kidney disease. Notably, the paper will set a discussion on the evaluation of renal function. Furthermore, the article will offer a succinct summary of the ideas concerning the thesis statement as shown below. When Glenda first attended Wurrumiyanga clinic at her home in Tiwi Island, the doctors had to screen her kidney to identify any symptoms of chronic kidney disease due to the physical symptoms she presented (Diamantidis nd Becker, 2014). Also, Wen et al., 2014) are of the opinion that screening helps in prescribing medical intervention for CKD at stages 1-3 hence appropriate procedural processes in combating the condition. That said, the following test helped the doctor in assessing the renal functioning and impairment for Glenda: urinalysis-the test makes use of urine, and with the inclusion of a urine dipstick the nurses can determine the presence or absence of bacteria and casts on a microscope. Urinary protein excretion-the model analyzes urine after every 24 hours to measure the albumin-creatine ration abbreviated as ACR. An increase in the ACR shows a high risk for cardiovascular complications. Renal imaging-the technique pays attention to the shape of the kidney and checks the presence of cysts (Fang et al., 2014). Notably, the assessment model is of significant role in patients with CKD stages 4 and 5. Also, patients with stages 1-3 ought to undergo an ultrasound in case of reduced eGFR. Finally, renal biopsy a patient with stages 4-5 CKD is advised to undergo the assessment to check the level of proteinuria. Britt et al., 2013 are of the opinion that renal biopsy is of great value as the histological analysis provides nurses with information to know when and how to diagnose the impaired kidney failure. There are five stages of chronic kidney disease that Glenda is diagnosed with: ranging from stage 1-5. The evaluation model follows the in-depth analysis of Glenda's medical history which reveals her physical symptoms: swollen face, feet, and hands, social life showing her smoking and drinking habits, and her family history which records no case of CKD (Angeli et al., 2014). The post-Streptococcal Glomerulonephritis diagnosis at Royal Darwin Hospital indicates that there was thickening of the membranes due to the accumulation of protein in the glomeruli hence need for checking the blood glucose levels (Tonelli and Wanner, 2014). Moreover, it is important to control the blood pressure to reduce the risk of proteinuria. In addition, Glenda's medical history at the time of admission indicates hypertension as blood pressure beyond 140/90 mmHg is considered hypertensive. eGFR more than 89/ml/min/1.73m2 but is not less than 59ml/min/1.73m2 (albuminuria included) Urea and electrolytes including eGFR. Scheduled clinical and laboratory assessment. Also, the nurses in charge offer advice on lifestyle practices. When the eGFR is less than 59ml/min/1.73m2 The inclusion of dipstick in the sample of urine collected to test for urinalysis for proteinuria. Regular checking of blood glucose levels. Analysis of full blood count to check the level of Parathyroid hormone (Levey et al., 2015). Also, the nurse reviews medical history and administers new medication which acts as an anti-inflammatory medication. The collected urine is assessed to check for urinary symptoms, heart failure, and hypovolaemia (Levey et al., 2015). For efficient management of the different stages of CKD, it is of significant value to first identify the symptoms associated with chronic kidney disease. What is more is that the clinical signs for CKD remain unrecognized until there is acute renal failure (Stevens and Levin, 2013). That is to say that a patient can be asymptomatic at an advanced stage of the condition. Therefore, early identification sets a platform for integration of early interventions which aim towards assessment and management of the state. As such, the symptoms of CKD include but are not limited to loss of appetite, nausea, minor ankle edema, change in urine pattern, and fatigue (Jha et al., 2013). Also, it is wise for Glenda to have a balanced diet characterized with enough proteins. Regulate the blood pressure to less than 135/80mmHg. Besides, inhibitors can be induced to slow the effects of renal deformity. Notably, when the eGFR reduces to less than 25% of the baseline value, it is important to cease the ACR inhibitor and refer Glenda to a Nephrologist (Mills et al., 2015) Schedule a workout program starting with walking the progressively to jogging and running: aim at improving the aerobic rate. Monitor the drinking patterns of Glenda. First, start with reducing then progressively rehabilitate her by stopping the supply and access to alcohol. Flu vaccination and pneumococcal vaccination During admission, Glenda needs to hydrate t avoid dehydration. Also, the nurses in charge can describe an antiviral medication. After being discharged Glenda can as well as use prescribed cough suppressant. Reduce the consumption of sugary coca cola drink from 500ml a day to 250ml then after some time you cut short and provide safe source of sugars such as Drink a lot of water to avoid thirst. Ensure Glenda consumes less salt: especially adding raw salt to the food at the table. Reduce the intake of coca cola and later cut short. Significantly, the End-Stage Renal Disease abbreviated as ESRD is the term used to refer to patients who are responding to the treatment from acute renal failure (Wen et al., 2014). Also, ESRD is commonly known as stage 5 of CKD. What is more is the availability of shared ideas between amongst nurses, patients, and their families: the ideas help in making informed decisions aimed towards treating stage 5 CKD (Locatelli et al., 2013). As such, the table below provides a description to types of treatment for stage 5 CKD. If it is critical it may call for surgery. Also, the period may wait for up to 6 years in case of deceased donor Glenda will be free to work and live a normal life. Moreover, Glenda has increased rate of survival after the transplant is done. Continuous Ambulatory Peritoneal Dialysis(CAPD) Automated Peritoneal Dialysis (APD) During the day four bags are changed by the APD entails the overnight exchange of bags by a machine The treatment ensures Glenda has the freedom to work without disturbance of the urinary tract: due to the PD catheter. The CAPD allows for ample time during one-week training. The APD allows the nurse on duty to rest. Requires no dialysis or transplant. It can be managed at the community level (Wurrumiyanga clinic). Again, the model is supported by palliative care Emphasizes on mediation and balanced diet. Non-dialysis supportive care increases survival chances in elderly patients thus increased life expectancy (Model, 2015). The nurse in charge of Glenda is working extra hard to avoid further complications of the conditions. Therefore, educating Glenda, her daughter Roseen and the community as a whole will ensure the sustainability and ease of combating CKD (Diamantidis and Becker, 2014). Notably, the primary risk factor identified is the danger of reduced cardiac output. The condition is associated with inadequate pumping of the blood to the heart to facilitate metabolic processes. The related risk factors include but are not limited to: first, fluid imbalances resulting in a lapse in the current volume and heart workload (Mills et al., 2015). Second, there is the risk of increased deposits of urea and calcium phosphate blocking the baseline membrane. Thirdly, lapse and alteration in electrolyte balance. The nurse can prescribe medication after observing and assessing the presented physical symptoms. To establish desired outcomes for Glenda the table below shows the nursing intervention and the possible justification. Analyze heart and lung sound to evaluate presence of peripheral edema and cases of dysponea. Diagnosed with flu hence wheezes, edema, and dysponea Assess the degree of hypertension and blood pressure Renal dysfunction causes hypertension. Also, orthostatic hypertension occurs due to imbalances in the intravascular fluids. Assess the presence of chest pains paying attention to the location and degree of pain Lack of potential risk of pericardial effusion associated due to home dialysis. Assess heart sounds, blood pressure, and temperature Narrow pulse pressure, temperature above 37.5 degrees Celsius, and presence of irregular hypotension. Assess and evaluate the physical activity Dormant nature alludes to HF and presence of anemia Need to monitor and assess lab and diagnostic results Potassium, calcium, and magnesium electrolytes When imbalanced they affect the heart functioning by altering the electrical transmission Used in identification of soft-tissue calcification Administering antihypertensive drugs such as Apresoline: a hydralazine Useful in reducing vascular resistance and tension hence reduce myocardial workload. Also, useful in preventing HF. Reduce accumulation of urea. Again, corrects the electrolytes and fluid imbalances. To exclude the pericardial sacs as it may result in cardiac arrest through myocardial contractility. The burden of CKD led to the longer hospitalization of Glenda, and it is important to include multidisciplinary care clinics to improve service delivery (Gatchel et al., 2014). The approach integrates different health professionals and family members to offer long-term support to Glenda as shown below. Assess and evaluate etiology of Glenda’s CKD to determine the care plan (Diamantidis and Becker, 2014) Offer advice on nutritional intake and manage the intravascular fluid Provide education to Glenda regarding effectiveness of modern medication and herbal treatment Substitute Roseen on transporting the mother to hospital Educate Glenda about transplant before the surgery (Davison et al., 2015) Provides education regarding CKD and acute renal failure. Also, coordinates care with Glenda’s family and the locals. Less attention has been paid to monitor the role awareness has to CKD patients. Although early identification proves to be a mechanism to slow the progression of CKD and ESRD, there is a growing need for the establishment of a customer-oriented platform for nurses to exercise to administer patient-center to patients such as Glenda (Papademetriou et al., 2015). Also, encouraging Glenda to attend guiding and counseling sessions in Tiwi Islands will help boost her morale and change her perception of life. And it is known that once the mind is stimulated so does the endorphin hence the body relaxes. The model will allow Glenda get back to her feet and provide for her family. In nursing, providing care, assessing, and management of diseases is a plan that allows nurses to incorporate Levett-Jones cycle of clinical reasoning: a period that allows for an understanding of the patient's past medical history and ethnic background before commencing with data collection and administering medication. As for Glenda the condition grows and gets of hand hence the inclusion of interdisciplinary team approach to offer long-term support emotionally, physically, and medically. To that end, it is possible to discern that CKD cannot be treated, but approaches as integrating family members and the community help to slow its progress. Angeli, P., Rodrà ­guez, E., Piano, S., Ariza, X., Morando, F., Solà  , E., ... & Gerbes, A. (2014). Acute kidney injury and acute-on-chronic liver failure classifications in prognosis assessment of patients with acute decompensation of cirrhosis. Gut, gutjnl-2014. Britt, H., Miller, G. C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., ... & O'Halloran, J. (2013). General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health (No. 33). Sydney University Press. Collins, A. J., Foley, R. N., Gilbertson, D. T., & Chen, S. C. (2015). United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney international supplements, 5(1), 2-7. Davison, S. N., Levin, A., Moss, A. H., Jha, V., Brown, E. A., Brennan, F., ... & Morton, R. L. (2015). Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care. Diamantidis, C. J., & Becker, S. (2014). Health information technology (IT) to improve the care of patients with chronic kidney disease (CKD). BMC nephrology, 15(1), 7. Fang, Y., Ginsberg, C., Sugatani, T., Monier-Faugere, M. C., Malluche, H., & Hruska, K. A. (2014). Early chronic kidney disease–mineral bone disorder stimulates vascular calcification. Kidney international, 85(1), 142-150. Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014). Interdisciplinary chronic pain management: past, present, and future. American Psychologist, 69(2), 119. Hung, S. C., Kuo, K. L., Peng, C. H., Wu, C. H., Lien, Y. C., Wang, Y. C., & Tarng, D. C. (2014). Volume overload correlates with cardiovascular risk factors in patients with chronic kidney disease. Kidney international, 85(3), 703-709. January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cigarroa, J. E., Cleveland, J. C., ... & Murray, K. T. (2014). 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol, 64(21), 2246-2280. Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., ... & Yang, C. W. (2013). Chronic kidney disease: global dimension and perspectives. The Lancet, 382(9888), 260-272. Levey, A. S., Becker, C., & Inker, L. A. (2015). Glomerular filtration rate and albuminuria for detection and staging of acute and chronic kidney disease in adults: a systematic review. Jama, 313(8), 837-846. Locatelli, F., Bà ¡rà ¡ny, P., Covic, A., De Francisco, A., Del Vecchio, L., Goldsmith, D., ... & Abramovicz, D. (2013). Kidney Disease: Improving Global Outcomes guidelines on anaemia management in chronic kidney disease: a European Renal Best Practice position statement. Nephrology Dialysis Transplantation, 28(6), 1346-1359. Mills, K. T., Xu, Y., Zhang, W., Bundy, J. D., Chen, C. S., Kelly, T. N., ... & He, J. (2015). A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney international, 88(5), 950-957. Model, C. C. (2015). Standards of medical care in diabetes—2015 abridged for primary care providers. Diabetes care, 38(1), S1-S94. Papademetriou, V., Lovato, L., Doumas, M., Nylen, E., Mottl, A., Cohen, R. M., ... & Cushman, W. C. (2015). Chronic kidney disease and intensive glycemic control increase cardiovascular risk in patients with type 2 diabetes. Kidney international, 87(3), 649-659. Stevens, P. E., & Levin, A. (2013). Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Annals of internal medicine, 158(11), 825-830. Tonelli, M., & Wanner, C. (2014). Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members. Lipid management in chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2013 clinical practice guideline. Ann Intern Med, 160(3), 182. Tong, A., Crowe, S., Chando, S., Cass, A., Chadban, S. J., Chapman, J. R., ... & Johnson, D. W. (2015). Research priorities in CKD: report of a national workshop conducted in Australia. American Journal of Kidney Diseases, 66(2), 212-222. Vassalotti, J. A., Centor, R., Turner, B. J., Greer, R. C., Choi, M., Sequist, T. D., & National Kidney Foundation Kidney Disease Outcomes Quality Initiative. (2016). Practical approach to detection and management of chronic kidney disease for the primary care clinician. The American journal of medicine, 129(2), 153-162. Wen, C. P., Matsushita, K., Coresh, J., Iseki, K., Islam, M., Katz, R., ... & Astor, B. C. (2014). Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar. Kidney international, 86(4), 819-827.

Operations Management Essay Example | Topics and Well Written Essays - 1500 words - 13

Operations Management - Essay Example The international nature that is evident in the markets as well as competition has made many of the companies that operate globally to make reviews to their operations strategy and the companies are thus moving from the centralized operations to the decentralized ones so that they can benefit from the accessible resources while being closer to the markets. The organizations have also made several changes in the approaches, techniques and operations they employ with the goal of meeting the evolving requirements associated with the market. Companies therefore have to be in competition on the basis of more than one competitive performance goals that include quality, cost, receptiveness, suppleness as well as reliability.Mass customization has therefore developed to be a key goal as in many of the companies and the organizations are developing the build-to-order supply chain so that it can be flexible and responsive. To accomplish mass customization, the build-to-order model has to be ac tively implemented in a variety of industries, company like BMW allows the customers to make changes to the vehicles that they want within six days of the final assembly and this includes an entire change in the colour of the car. This enables the company for example, to build more than half a million permutations of the Z3 since they can be tweaked to the customer’s specifications in the event that he or she wants adjustments.As a result of the escalating international competition as well as a decline in the profit margins.